Infertility and Embryo Donation

Embryo donation does not receive much publicity, yet it is important for people with infertility to know about it, as well as about embryo adoption, which I will discuss in next week's blog. Today I will focus on the donation of remaining embryos from one couple's IVF treatments to another couple, followed by the placement of those embryos into the recipient woman's uterus for the purpose of pregnancy.

When an infertile couple's treatment enables them to produce embryos, they very likely begin by having some of those fresh embryos placed via in-vitro fertilization into the woman's uterus, with the remaining embryos frozen for possible later use. If an implantation occurs, followed by a healthy pregnancy and successful delivery, the couple still have the option to use the frozen embryos at a later date in an effort to have more children. However, at some point the couple will decide that they will not use any more frozen embryos, either because they have been able to have their desired number of children or because IVF has not been successful and they have decided not to pursue future IVF efforts.

So the question becomes what to do with any remaining frozen embryos. The options available to the couple at this point include keeping them in frozen storage, asking that the embryos be thawed and disposed of, donating the embryos to stem cell research or donating the embryos to an adopting couple. There are currently 500,000 frozen embryos in the U.S. and one million worldwide. So why is the option of embryo donation not considered by more couples? For the most part it has to do with their emotional ties to the embryos and the reluctance to address their inevitable grief as they donate the embryos to another couple hoping to become the gestational parents.

Having put a great deal of time, expense and emotional energy into creating the embryos, a couple will want to be very certain they will not seek to achieve another pregnancy. The couple also may consider these embryos to be extensions of themselves, and in that sense have a genuine emotional attachment to each embryo, which could be considered a potential child. Thinking of donating their embryos can feel like letting go of an important part of themselves, and many potential donors resist the inevitability of the grieving that will accompany a decision to donate. Yet to allow their embryos to remain for years in storage presents its own set of dilemmas.

Yet many couples with stored embryos have a very real appreciation for the emotional yearning of infertile couples unable to give birth to a baby with their genes. The empathy they feel for couples whose treatment for infertility has been unsuccessful can promote a willingness to address the emotional grieving process in order to proceed with donation of their remaining embryos.

Well over half of embryo donations are anonymous donations, but the legal option exists for a donating couple to specify that they want an semi-open or an open embryo adoption. In an anonymous donation/adoption, medical information about the donors would be disclosed to a couple adopting the embryo(s), but no other identifying information. A semi-open donation/adoption could include sharing such information as family interests, first names, e-mail addresses, but not a mailing address. An open donation/adoption would typically include an initially signed agreement, specifying the level of contact with which both couples are comfortable.

So, as I find myself moving more toward sharing information about embryo adoption, I encourage you to stay connected and keep your eyes open for next week's blog on that subject!

The issue of donnation or adoption of embryos is still a very sensitive issue in assisted human reproduction as in vitro fertilization. Some countries, like Spain, which allow the freezing of embryos for five years and after this period requires their destruction. In Denmark the survivors are destroyed immediately after fertilization, without cryopreservation. Others advocate the idea of donating embryos for research purposes, as in the United States and Belgium. Im my view the ideal procedure is in Germany where it is not allowed to generate more embryos than what is needed to deploy.

There are many crooks and predators in the reproductive technologies field, some with impeccable credentials who do not make a financial disclosure to better explain why they are so passionate about this or that cause in a fertile ground.

But you aren't one of them. You are genuinely in the market of promoting adoption for equally benevolent sterile couples. Your cache of stalled human embryonic stem cell masses, or cryogenically preserved ivf embryos, was collected from and is the property of genetically healthy individuals that were and are fully informed, and fully consenting and fully in control of the future fate of their distinct life form in storage. You are here to guide us to the science that will make clear the risks of the process and the stats on existing ivf humans. You are not expecting coerced donations, and macabre experimentation, you are here to reassure the public and to lead the policy. What a good little darling, you are, what a good little steward you are, of our dormant cells.

Two good sources of information on embryo donation and adoption are www.embryodonation.org and www.embryoconnection.org. The first site directs you to The National Embryo Donation Center (NEDC) , a non-profit organization whose mission is to protect the lives and dignity of human embryos by promoting, facilitating and educating about embryo donation and adoption. The second website contains information about embryo donation and adoption, grouped by topic areas as follows: adoption agencies, public policy, bioethics, law, news media, medical research and other resources. Lists of various entities performing embryo donation and adoption are also included. Both sites have interesting blogs from both donor and recipient families.